SPR unknown #32 -- Final

Andrew Lemmon, MD

Kiery Braithwaite, MD

Adina Alazraki, MD

Emory University Hospital

Keywords

SPR unknown 32 hydrocele


Publication Date: 2010-06-30

History

8 week old with palpable abdominal mass

Findings

Ultrasound: Large cystic mass extending from the scrotum to the umbilicus. Normal appearance of the testicles.

Diagnosis

Abdomino-scrotal hydrocele

Discussion

A hydrocele is a fluid collection within the tunica vaginalis. The tunica vaginalis is an extension of peritoneum that follows the testicle into the scrotum during development and fuses after descent. Failure of fusion at any point along the course allows fluid to accumulate in that region. This can occur anywhere along the tract, but most commonly occurs in the scrotum adjacent to the testicle. When the entire tract is unfused, peritoneal fluid freely communicates via the patent processus vaginalis into the scrotum. An abdomino-scrotal hydrocele is a rare form of a hydrocele where the entire tract is unfused, except at the deep inguinal ring. As fluid accumulates, the hydrocele can bulge into the abdominal cavity, causing both a scrotal and an abdominal component, forming an hourglass shaped cystic structure about the deep inguinal ring. Hydronephrosis and leg edema can result from compression of the ureters and iliac veins, respectively. Less likely, torsion of the proximal sac can occur. Surgical resection is recommended for abdomino-scrotal hydroceles to prevent complications.

References

  1. Puneet MS, Tiwary SK, Gupta SK, Singh S, Shukla VK. “Abdominoscrotal Hydrocele.” The Internet Journal of Urology. 2006 Volume Number 2.
  2. Fenton L Z, McCabe KJ. “Giant unilateral abdominoscrotal hydrocele.” Pediatri Radiol. (2002) 32: 882-884.
  3. Siegel MJ. Pediatric Sonography, Third Edition. Philadelphia: Lippincott Williams & Wilkins, 2002.

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